Form Ia 15 - Change Of Business Information Form For The Unemployment Insurance Program


Department of Labor - Unemployment Insurance Division
Registration Section
W A Harriman State Campus
IA 15
Albany, N.Y. 12240-0339
New York State Department of Labor
Employer Registration no.
Change of Business Information form
for the Unemployment Insurance Program
Employer Legal name
Return completed form to the address shown above
Street or PO Box
or fax to (518) 485-8010
ZIP Code
Need Help? Call (518) 457-5806
Signature required on reverse
Part A - Federal Employer Identification Number
1. Enter your Federal Employer Identification Number (FEIN) if your FEIN was not previously reported, is
is incorrect, or you have reported under an ID other than your FEIN. Also, enter your new FEIN if it has
changed as a result of a change in business entity, and complete Part B.
Part B - Discontinuance of Business/Change in Ownership/Name Changes
1. If your business or employment in NYS was permanently discontinued, indicate the date this occurred
2. Indicate if your business in New York State was sold or transferred:
Enter date of transaction
Name of new owner:
Address of new owner:
3. If ownership*/business entity [i.e. partnership, sole proprietor, corporation, limited liability company
(LLC), limited liability partnership (LLP)] has changed, enter the date changed
Please explain:
*A corporate stock transfer or sale does not constitute a change in ownership for Unemployment Insurance purposes.
4. Name Changes:
If your business is a corporation, LLC, or LLP, you must make any legal name change with the Department of State
(DOS). Please contact DOS by telephone at (518) 473-2492, or write to: 41 State Street, Albany, N.Y. 12231. DOS
will process the name change and notify this agency accordingly.
Enter Date of Change
If your business is a partnership and there has been a change in partners, does your partnership agreement
allow for a change in partners without a dissolution of the partnership?
Name of new partnership:
If there has been a change in your trade name (doing business as), enter the new name:
5. If your business is a corporation and there has been a change in corporate officers, your business is a partnership and there has been a
change in partners (including LLP's and RLLP's), or your business is a LLC or PLLC and there has been a change in members, indicate
if an officer/partner/member is being added or removed (Del.), by completing the information below.
Social Security
account no.
See reverse for address corrections


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